A Case of Chronic Obstructive Pulmonary Disease (COPD) Followed by Pulmonary Rehabilitation

We report a 75-year-old woman with chronic obstructive pulmonary disease (COPD) suffering from cough, sputum, high-grade fever and dyspnea on effort. Her chest radiograph revealed an infiltrative shadow in the right lower lung field and her laboratory data showed marked inflammatory changes. Her arterial blood gas analysis showed marked hypoxemia and hypercapnia. After her laboratory data and general condition improved, we performed pulmonary rehabilitation for the patient for about 6 weeks. The program consisted of pursed lip breathing, diaphragmatic breathing, muscle stretch gymnastics, and walking. The 6-minute walking test distance increased from 170m to 280m. The minimum SpO2 during the 6-minute walking test increased from 88% to 91%. (O23L/m) After discharge, she continued to receive home care from a visiting nurse specialized in respiratory medicine and 24 hour-monitoring of O2-compliance at home. She has not experienced acute exacerbation or re-hospitalization for 1 year. We conclude that home care service is effective to maintain stable conditions such as state of breathing, SpO2, vital signs, and activities of daily living for elderly COPD outpatients.